Senior Director Revenue Cycle

Description

THE ROLE

The Senior Director, Physician Billing Revenue Cycle Operations, will be responsible for the management, implementation and execution of clinic revenue cycle improvement initiatives and to act as the liaison between stakeholders of the clinics and the Shared Service functions provided to the clinics including insourced and outsourced revenue cycle responsibilities.

The position will be responsible for process improvement work to optimize people, processes and technology throughout the revenue cycle and must have in-depth knowledge of ambulatory revenue cycle including scheduling, referral management, insurance verification, registration, charge capture, coding, claim processing, denial management and account receivable lifecycles.

This position is responsible for building effective partnerships and promoting collaborative relationships with Providence Clinical Networks' Financial and Clinical leaders, caregivers and physicians. This leader continually evaluates the end-to-end revenue cycle processes to maintain best practice standards and realize service and quality commitments, ensuring that key stakeholders are kept fully informed on performance and important factors influencing it. This leader maintains current knowledge of industry trends and regulatory requirements and has considerable expertise in payer contracts.

The position requires a hands-on, self-motivated individual who thrives in a fast-moving, dynamic environment within a challenging and evolving industry. This key leader champions a mission-driven culture that embodies the organization's core values of compassion, dignity, justice, excellence, and integrity. This leader must inspire, mentor, and cultivate critical relationships with to executives to drive operational outcomes in their assigned region(s).

ESSENTIAL FUNCTIONS

• Analyze and monitor key performance indicator to develop strategies to meet or exceed best practice performance. Facilitate workgroups and develops/implements actionable strategies to maintain results with emphasis on an efficient and effective revenue cycle; improving collections, reducing bad debt and denials, and creating positive patient and provider experiences.

• In collaboration with PCN leaders, recommend Epic and other system enhancements to drive necessary efficiency and performance.

• Manage applicable means of communication for stakeholders at all ministry locations that outline the avenues for success, potential barriers to avoid, and appropriate actions to take, etc., to optimize Revenue Cycle processes and efficiency.

• Develop, maintain, and oversee consistent, focused front-end revenue cycle feedback loops to clinic and provider operations.

• Ensure client facing deliverables (e.g., reports, meetings, agendas, presentations) are delivered in a timely and accurate manner.

• Advocates for the optimal provider experience and is able to effectively communicate operational needs from providers to the shared services operations.

• Establishes standards and processes to ensure continuous improvement in the revenue cycle.

• Informs and partners with data and analytics team to build robust reporting which provides insight into the drivers of revenue cycle trends in ambulatory services.

• Represent revenue cycle on key committees to help move to common standards and practices, while providing input back to the revenue cycle on clinic needs for variation and best practice.

• Point of contact and escalation for revenue cycle issues and concerns. Work with revenue cycle leadership to resolve and assure the resolution is communicated timely to the clinics. Monitor raised issues for outcome and closure.

• Establish relationships with key ambulatory leaders. Provide revenue cycle guidance during strategic initiative discussions.

• Participate in professional activities and affiliations to maintain knowledge of trends and changes in the health care environment.

• Actively supports and incorporates the mission and core values into daily activities. Treats all others with respect and demonstrates excellence, justice and compassion in daily work and relationships with others.

• Maintain confidentiality of all information related to patients, medical staff, employees, and as appropriate, other information.

• Demonstrate service excellence and positive interpersonal relations in dealing with others, including patients/families/members, employees, managers, medical staff, volunteers, vendors and community members, so that positive relations are maximized.

• Consistently demonstrate and incorporate principles of safety and infection control into daily activities as outlined in Environment of Care, Infection Control, and Exposure Control manuals and department safety policies/procedures. Maintains knowledge of work-appropriate aspects of environment of care programs complies with policies and reports unsafe conditions. Successfully completes Environment of Care HealthStream modules in the required timeframes and participates in fire drills and emergency exercises.

QUALIFICATIONS

• Bachelor's Degree in Healthcare Administration, Business, Finance or relevant area of expertise; or equivalent educ/experience

• 10 or more years of progressive responsible experience in Healthcare Administration and/or Operations with an emphasis on management, business or account management

• 8 years of leadership experience

• 2 years of in-depth experience with Epic (or similar system) and an understanding of best practice infrastructure to drive optimal revenue cycle performance

• Advanced Ability to analyze and interpret financial data

• Advanced Demonstrated problem-solving skills

• Advanced Ability to build strong customer relationships

• Advanced Ability to lead/manage others

• Advanced Ability to represent the company with external constituents

• Demonstrate knowledge of revenue cycle concepts and issues for ambulatory services

• Demonstrate outstanding public relations and interpersonal skills

• Ability to problem solve complex issues

• Excellent critical thinking skills

• Proven organizational skills

• Excellent verbal and written communication skills

• Ability to maintain in-depth knowledge of Federal, State, Local, and contract specific requirements

• Ability to multi-task, remain calm in stressful situations, and to make quick and appropriate judgments to address various situations

• Ability to act independently, guided only by broad organizational policies and objectives

• Proficiency in MS Office applications, including Excel

• Demonstrated ability to perform in alignment with company mission and values

• Demonstrated knowledge of HIPAA rules and regulations.